Docs want to check hunters

Neurologists in Denver want to examine hunters from northeastern Colorado
showing early signs of dementia to assess whether they could have contracted
human cases of chronic wasting disease.

The research, to be overseen by University of Colorado Health Sciences
Center
doctors, comes as the state health department plans to review decades' worth
of
death rec-

ords to see if deaths related to brain diseases are uncommonly high in
Colorado's CWD endemic area.

Patrick Bosque, a neurologist at Denver Health Medical Center, said it's
time to
look more directly for patterns linking CWD with human deaths, because
experimental models designed to answer the question of human susceptibility
aren't working well enough.

"The only way we're going to know is if we see an outbreak (of dementia-like
brain disease in humans) that can be tied back to deer and elk consumption,"
said Bosque, whose mice experiments relating to human risk of CWD are
inconclusive. Looking for cases in the northeastern Colorado endemic area is
the
obvious way to go, he said.

"A lot of science comes down to common sense," Bosque said. "If (CWD) is
transmissible, that's where we're going to see it first."

Bosque said the study involving living hunters and perhaps others who
consumed
venison frequently would likely involve mailing letters to neurologists and
primary care clinics, who would refer dementia patients from northeastern
Colorado for a formal evaluation at CU Health Sciences Center.

Among things neurologists would look for: A pattern of deterioration similar
to
other prion diseases. Prions are rogue proteins believed to be at the root
of
CWD, mad cow disease, and a related human disease called Creutzfeldt-Jakob,
or
CJD.

"We'd want to see something that's getting worse," Bosque said. "Prion
diseases
progress fairly rapidly; they're not something that progresses over a
10-year
period, something on the order of a month-

to-month, steady worsening."

The long incubation period of prion diseases could make the assessment more
difficult, Bosque said. Someone could have stopped eating venison decades
ago
and, in theory at least, show symptoms far later.

Citing a related degenerative disease, called kuru, that struck tissue-

eating cannibals in New Guinea, Bosque said scientists discovered incubation
periods of 30 to 40 years.

The Colorado Department of Public Health and Environment, meanwhile, is
contracting with statisticians at the CU Health Sciences Center to crunch
death
records for diagnoses of dementia-like diseases such as Alzheimer's,
Creutzfeldt-Jakob and senility to see if unusually high numbers of those
causes
of death appear in northeastern Colorado compared with rates elsewhere in
the
state.

State epidemiologist John Pape actually sought the $22,000 study a year ago,
but
was initially turned down for funding by the Centers for Disease Control.
Now,
with money in hand, he hopes to see the work completed by early next year.

"It wouldn't tell us, if we saw higher rates (of brain diseases), that it
was
CWD," Pape said. "But it would be a roadmap, telling us maybe we ought to
look
at this more, or look at some of these cases to see what occurred there."

Pape said health officials in Great Britain conducted a similar analysis -
seeking 30 to 40 diagnoses for deaths linked to neurological diseases -
prior to
the outbreak of the human form of mad cow disease, when they were still only
wondering if the disease could make the jump from animals to people. Since
then,
135 cases have been documented in humans. Even so, the early statistical
analysis failed to pick out any glaring patterns.

If the Colorado study did show unusually high death rates from brain
maladies in
the endemic area, health officials would have to take additional steps,
including looking at old medical records and talking to surviving family
members.

"It's kind of a crude measure," Pape said. "What I think it will show is
nothing, that people who hunt in those counties probably don't die of a lot
of
strange neurological diseases any more than people in the southern and
western
part of the state, where CWD hasn't occurred."

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